Wednesday, December 31, 2008

Normally after a victory or a success, we celebrate it and remember it as the one of the sweet moment in our life. For example, we celebrate a work promotion or strikes of A's in college exam. Another example, for Muslims, Hari Raya is celebrated after one full month of fasting.

I had dinner with bunch of my friends on the night of new year, before one of them asked me, "Where are you going to celebrate new year? Then suddenly this question come across my mind, " Why do we have to celebrate new year?" What are we celebrating for? Last year victory? (if any he.. he...) Have you achieved something great last year?

There was a long pause and nobody seems have to good answer for that, neither I. Since new year is public holiday, maybe we just should celebrate it he he........ Sometimes, you don't need good reason to do things. Happy New year everybody!!!

Monday, December 29, 2008

I went to one of the Tower record outlet yesterday to check out the latest CD . Suddenly I saw this 2 and half years old cute little boy with his grandfather sitting in front of the big screen in front of the music outlet. He gave 101% undivided concentration to the movie, make himself comfortable like in his house and totally ignoring the crowds. He did really enjoy the movie and the whole scenario look very sweet to me (it looks very sincere). It reminds me, a child will never lies. They will give the most honest opinion that you can get with no hidden agenda. Emm.... it sound like something that we must must learn from them rite?....(thinking)...

Thursday, December 25, 2008

Stress can manifest with multiple presentations. Some might have increased appetite while others might have just have difficulty to sleep at night or the opposite. Stress is equal to mental sickness. It just sometimes very difficult to be diagnosed because you might not aware about it. Mental sickness also can also can cause psychosomatic symptoms (meaning your your mind believe your physical is sick and you can feel it for real). A friend of mine told me that he had a very bad migraine recently, but when i had a conversation with him, i think he is under a lots of stress. A mind vacation is rather helpful rather than taking pharmaceutical medication.

Saturday, December 20, 2008

I had a this conversation with one of the very senior ward's sister (head of the nurses) who is very dedicated and experienced 2 years ago. I really respect her because she had more than 25 years working with thousand of doctors of different generation and handling millions of patient in different decades of her service. She told me that :

" As medical service provider, when you come to work, you are like wearing an opera mask with heavy make-up. Leave all your personnel's life aside. Patient life is your priority. When you get scolded by the patient or received bad complaint despite your hard work, just smile and swallow it. Keep doing your work and responsible. God will pay all your good work later"

which I, totally agreed with her and I still clearly remember each of her word.

Recently there one or two article in the news paper complaining about medical service and I suddenly recall her word again. Believe me, it is not easy handling sick patient. They need more attention than usual. With limited resources, the attention is given more to those who need more i.e more seriously ill patient. As a result, more stable patient need to wait longer time. But from my experience, most of the dissatisfaction, are caused by miss communication and misunderstanding between the health care provider and patient. At the end of the day, it is not easy to satisfied everybody no matter how hard you tried.

The next question is, why our resources are limited and why we can't practice efficient medical system as in western countries. The reason is very simple, most of medical staff are overwork, underpaid but what they get at the end of day is only series of bad complaint about them. Not fair right? So, they leave the government service as a result of their frustration. This is not my theory as it is happening in front of my eyes.

For most of western countries, medical service is paid by patient's medical insurance. So physically, every hospital is like private hospitals in Malaysia. It's totally opposite of our system where, you pay 5 ringgit and you get most of the medication FOC. If the same system implemented in Malaysia, i believe, a lot of patient is not properly treated because medical insurance itself is not cheap.

I also believe, Malaysia Ministry of Health is trying their best to improve Malaysian health system and really hoping they will give more attention to the problem when providing the service. Money is not everything.

Thursday, December 18, 2008

There are Mega sale everywhere in KL! My advice, stay away from KL mega-shopping complexes, keep your credit card in safety box and do not, i repeat do not window shopping at this as this can cause Post-shopping depression (esp when you get your credit card monthly statement he he). This is not a new disease but no effective treatment so far. Few drugs is still under research the the result is not very promising he...he..

Dr F and I was collecting information (not shopping) for our new project at The Pavilion before our steps stopped by the astonishing giant Christmas tree at the main entrance. For this year, the best Christmas tree decoration goes to The Pavilion. KLCC is recycling their gigantic Christmas tree for the third consecutive years. Maybe the they try to save the trees (or save their budget he.. he..)The night view of this Christmas tree....

While doing some .......... err... data collection for my research, I bumped to this mother with her daughter with a innovative anti-thief/anti-child-missing-device. (Please refer to the picture above) The small little cute child was wearing a small knapsack ,with a long tape attached to her mother's wrist. It looks very practical to me as this the prevent unnecessary announcement of missing child. Personally, I think more parent should get this kind of thing as a small investment for their child safety. If wearing seat belt for the back passenger might save the front seat passenger, wearing this safety anti-child-missing-device might save your child. Thinks about it.

Saturday, December 13, 2008

Not all of us have a Cinderella type of love story (love at first sight, get married and live happily ever after types of story). Trust me, life is not as simple as that. A friend of mine had his own story. He is 100% ready for commitment as full time lover but what he get at the end of day is only serial episodes of frustration in his relationship. As wise man says, "You can never get all what you want" and i always believe that. Luckily he still believe in love in still searching for it.

Another friend of mine had different story. She got married to somebody that she "thought" that she knew very well , had a very cute little daughter and left by her husband recently because her husband not sure what he want in his life. Sound ridiculous right? She still feels very sad as his daughter will grew up without father and she not sure how to explain to her daughter when she asked about her father. She still partly believe in love. Good for her.

Wait, there another sad love story. Another friend of mine. She had 3 boys after 5 years of marriage. Looks older then her age. Her face tells everything. She don't ever have to speak. She had suffered a lot from her marriage. She has been totally abandoned by her husband. She rising her kids by her own despite having a husband. The only reason is because her mother in-law does not like her and at the same time, her mother in-law has already arranged somebody for her husband. She try to stand still in her marriage because of her kids. Do you think she she still believe in love? hurm......(thinking).......

Monday, December 8, 2008

My friends and I had a wonderful weekend last week. We had travel thousand miles across 3 countries via 4 ports (seaports) to 5 big cities in 72 hours. Sound great huh? he... he... I'll show the route map.

This round, there no "road block" or "de-tour". All the routine must be done by all contestants. I have to admit, it's a long tiring journey but trust me the it really worth for your money and time he he... Lets have a look for some breathtaking moments.

This is how Malaysia looks like from ferry leaving to Batam. Pretty isn't it. The picture tells everything.

This is the view taken from the first from total of seven Batam Great Bridge. The seawater is jade green!

A fisherman village at Bintan. The steel rods, obscuring the great view.

This is where we stay at Bintan

Sunset at Bintan from our floating water resort

This bird give us a wake up call!

Well roasted and well blended black coffee served in old style Chinese cup with perfect morning seaside view is good starter for another long journey.

Tuesday, December 2, 2008

I must say, I hates December so much when it comes every year. It reminds me all the unfinished business, unfulfilled dreams and the untouched works for the whole year. It all make me so depressed. To add the so called "enjoyment", we going to celebrate new years soon which technically make me and all of you a year older (or people like to mention it, a year wiser). Now we have to adjust with the "new" age. I wish December never comes. Why time have to fly so fast? Why oh why?..... sigh....

Wednesday, November 26, 2008

A 21 years old Malay man who is a C*lcom service operator, complaint or sore throat

HappyDoc comment

This case is straight forward. There was no other associated symptoms. From examination he had simple upper respiratory infection (mild) which usually resolved spontaneously most of the time. He asked for one day leave so that he can recover quickly and regain full energy which I think a reasonable request.

We have a brief talk and he told me that he just dropped out his diploma recently and doing his current work as contract basis. He is a cheerful and pleasant types person with good communication skill. He had a bright ambitious face. I advised him to pursue back his study as he is still young and he still have a lot more to learn about life. I believe that he can be a successful person one day. Sound like..... I concern to much .... or maybe it's a sign of aging he he (err...when you start to concern too much and talk a lot he he) and I do like the term aging gracefully very much. Do this term applied to you..........?

Monday, November 24, 2008

60 years old Malay lady with background of diabetes, complaint of generalized body weakness

HappyDoc comment

Hurm... A little bit difficult to tackle this lady problem since the complaint is not very specific. Various medical problem can cause generalized body weakness. She controlled her diet well and she just visited her regular doctor recently and was added new medication. On further questioning, she do feels hungry, a bit sweaty and palpitation. A ha, that clue was really helpful! A simple and quick glucometer revealed that her blood sugar is 3.0 mmol (which is very low) She had hypoglycaemic symptoms!HappyDoc action

She need glucose to correct her hypoglycaemia. Since she was still alert, i immediately grab lollipop and give it to her (the lollipop is reserved as bait for children who did not co-operate during physical examination and it look very cute for a 60 years old granny eating lollipop). But all her symptoms quickly resolved after that.

HappyDoc concern

It will take hours taking about diabetic and the complication. Diabetic is not all about treating blood sugar level alone. Education is the most important part and managing the complication is even harder. A home blood sugar monitoring will alert those with diabetic if their sugar is not well controlled. You need to balance between hyperglycaemia (excessive sugar) and hypoglycaemia. Yeah....It all about balance, like Ying and Yang and just like how hard we try to balance between our work and family (i.e as son/ daughter and as father/mother). It was never easy right?

Wednesday, November 19, 2008

I received a bad new today. One of patient that my team and I has been taking care for the past 3 months lost her battle. She passed away yesterday due to post-operative complication. It give a big shock to us for a while after my team and I visited her empty bed at ICU today. She was a very pleasant lady and optimist person to start with. She looking forward to do the operation despite knowing the risks and she might not seeing again the world after the operation. She did very well on day 1 until day 3 after the operation before everything turn to a mess yesterday. I feel very sad for her but a part of me telling me that she died for what believe for and she did what she feel right for her. May Allah bless her and placed her with good people. Amin

Saturday, November 15, 2008

I did locum (part-time work) at a private clinic yesterday and I've come across these 3 cases:

Case 1

A 19 years old healthy Malay boy who is a cook complaint of insomnia for the past 1 week.

HappyDoc comment:

I need to exclude if this boy had symptoms of depression or taking any stimulant types of drug as this can disturb your normal sleep pattern. The most important question to ask is the lifestyle. If he took a lots of caffeine late night, this can be one of the cause. This boy admit that he work in the shift basis and the symptom worsen when his shift changed. He claimed that if he did not have adequate rest, his work performance on the next day will be affected. He also denied taking sleeping tablet before.

Most of the cases, lifestyle modification alone is adequate. Play some sport in the evening, avoid caffeine after 6pm and do not sleep during day time alone do help fighting your insomnia (Or in other word, practice healthy lifestyle)

HappyDoc action:

I prescribed him just a few tablets sleeping pills with lots of advised (Hurm... I don't know weather he listen to my advised or not) I told him, regular intake of sleeping pill can cause addiction and if he get caught by the police and get his urine tested, he might be face with lots of trouble. I advice him to take only when he really need it.HappyDoc concern:

Overdose of sleeping tablets can cause death. I don't want this to happened and that why i only gave him 3 tablets only to be used in desperate night. My other concern is he might use it for wrong reason like putting the sleeping pills in the somebody's drinks and do bad thing(figure it out itself, think outside the box he he). My other thought is he might be cheating on me. He is actually a sleeping pills addict he he... Err, maybe all my concern is not true. Probably, I think to much he he...

Thursday, November 13, 2008

It just a normal working day and i am in the lazy mood for this week (he he...) Then suddenly my hardworking ward clerk pass me a card. Initially, I thought it was a wedding invitation card as school holiday is around the corner but i was totally wrong. It a "Thank you" card from one of my patient who just discharge few days ago. Well, i don't expect it from her and her family as my team and i treated her same as other patient (as stated in our oath). But the good thing is it lift up my mood to work harder on that day.

I realized that a simple thank is rather important. If your staff done a good work, praise them and say thank you to them. If your mother or spouse cook a meal for you, do not forget to thank them as well. Believe me, cooking is not a simple task he... he..and i would like to thank you (yes you) for reading this entry he he... Have a good and productive day everybody : )

Saturday, November 8, 2008

What is your blood type?General speaking,O -ve = universal donor (generous type of person, scarifies her/himself for other need he he)AB +ve = universal recipient (he/she can received all types of blood but can only donate for those with same group. What does it sound like?... Selfish? he.. he..)err... well, this is not totally true actually..

I decided to do something good today. It takes very little effort but lots of courage to do it. I heard the in the morning news, that Malaysia blood bank had a shortage of blood. No wonder it is so difficult to get blood for patient in the ward nowadays. It's a considerately quiet day for me at work today. So, after work decided to drive to PusatDarahNegara at Jalan Tun Razak for blood donation (sound noble huh he.. he..) This going to be my 6th blood donation over 8 years period. I tried to do it more often but time is the constraint factor. My blood group is O negative, so you decide what types of person I am he... he...

This is my hand with needle in-situ. (I tried not to cry when the nurse poking the needle he.. he... hey it's painful OK, try yourself)

1 pack of blood = 450 ml = 1 life saved

If you are a healthy person, be a good citizen and donate your blood today. Lets do a little contribution for those who need.....

Monday, November 3, 2008

Dr Frapp and me was attending a weekend seminar recently at Melaka, the historical city. It was a fully sponsored trip and I must thanks AZ for organizing such a great event. Everything went smooth until Dr Frapp and me decided to get back to KL earlier since we already had personnel programme planned earlier. Dr Frapp and me leaving the hotel after had our dinner there.

The first half of journey was considered quiet boring. Then, suddenly a saw very thick mist on the other side of the road. I start to feel uneasy but i did not mention about it to Dr Frapp hoping that it's all my illusion. Few minutes after that. there was funny noise from my car. Shooot... why things must go wrong in the middle of the night and we are 128 km away from KL. I slowed down my car and park it at the roadside. After having quick unprofessional look, i noticed that my timing belt is 1/4 gone. To make thing worse, i cannot start my engine after that. Now we stuck in the middle of nowhere and in the middle of night hu.. hu.... (But I kind of enjoys it actually he he.. A dull predictable life with everything goes smooth is sometimes boring right? he he) But I definitely freak out if I was alone at that time....This is where the event take place.

Help from PLUS came after we waited 1/2 hour in dark. I managed to start back my engine and we decided to get back on the wheel and drive slowly to KL like 50 km/h... So, 128 km from KL, driving at 50-60 km/h.....Yeah you do the calculation.........Dr Frapp and me were singing together all along the way as we tried to minimize my car energy usage by not turning on the radio (I realized later this action was unnecessary he he) and we quiet enjoy it he he...

We finally reached KL at 1 a.m tired and sweaty. Our total journey is 4 hours instead of 2 hours. That night trip would be the longest journey ever from Melaka to KL but it going to be the unforgettable one. Today, I learned a new lesson, "It is not how fast you can get to your destination matter but how and whom you share your journey with is more important........."

Saturday, November 1, 2008

My younger brother had an accident recently. He was on his motorbike with his friend before a reckless lady driver in a white Kancil hit my brother from the back. He felt, kiss the road and hit his face badly leaving multiple abrasion wound.

To make thing worse, he loss his consciousness after the accident and he was bought immediately to Hospital Serdang.Lucky for him, he regain his conscious but he couldn't recall anything about the accident even where the accident took place. The last thing that he can remember is he is eating mee bandung and the next thing happened is he wake in hospital bed with wound all over his body. Thank God (Almighty Allah) he had no neurological deficit and his CT brain was normal, no intracranial bleeding. My diagnosis is: cerebral concussion with multiple superficial abrasion wound (especially over the face-habislah saham jatuh).

The not so good thing is, his convocation day (for his degree) is in 4 days time. Just imagine he is going to walk on the stage, received his scroll with face full of scars, had picture taken, and that picture is going to be hang in my parent house permanently. But wait, take it from the positive site, at least he can take the scroll by his own rather than somebody else take it for him. And that convocation picture, i believe that a little touch from photoshop will solve the problem right he he... there no problem without solution...

Tuesday, October 28, 2008

My house has been invaded by rat. And this rat has leave unwanted "fertilizer" in my kitchen. It's going to be very embarrassing if a doctor had leptospirosis (a disease brought by rat) and this directly reflects my hygiene. I decided to give this nasty little rat a lesson. So, I bought a rat cage with a undeniably delicious cream cracker inside the cage as a bite. Guess what, BINGGO! on the next day, a small black rats trapped in that cage. I thought that going to be the end of story, but new problem arise. Err... what I am going to do with that rats? I'm in dilemma!

The criminal in the cell

Call her Mickey (I just gave her that name he.. he..)

I've ask few of my friends, and these are some of their suggestions:

1. Just throw the rat in the jungle. 2. My grandparent used to kill them with boiled water.3. Throw in the river then. 4. Make peace with her, let it go. She learned her lesson.5. Turn the rat into rat satay. Must be delicious.Now, Mickey is in the cage waiting for her sentence. I leaved her outside my house while thinking what should be done. Would you guys help me? hu... hu....

Saturday, October 25, 2008

For most of medical devices, there will be only 1 device per packet. This is practiced to maintain the sterility of that particular devices. I am preparing to take my patient's blood in late afternoon to check her oxygen level. Suddenly i noticed something was not so right when I'm grabbing the packet of syringe. This particular packed that I'm holding contained 2 syringes! Which i never encountered since i practice medicine for the past 5 years. I decided that would be my lucky syringe. My guess is, something great is going to happen on me he... he... as always said, good things always come in TWO......

It was lunch hour on a rainy afternoon. This is another chronic patient of mine (considering she has been in hospital for 2 months) and this this 2 kids is her grandchildren. As everybody knows, hospital meals, are suc*s. What happened on that day, this two cute kids were bringing their grandmother lunch in a small classic "mangkuktingkat". It just like one of the memorable Petronas commercials. I just couldn't find the exact word to describe that sweet captured moment. This poor auntie was so excited to see her grandchildren and at the moment she smiles, all her disease/burden seem to be cured/relieved temporarily. This all reminds me that, small things does matter in our life. Even a simple thing like sending text messages to your parents or friends can be very meaningful to them. So, start doing it today ......!